Keyhole surgery to close the left atrial appendage versus medicine in atrial fibrillation
Compares keyhole closure of the left atrial appendage with medicine in atrial fibrillation.
Plain-language title generated from the registry record
Registry title: Standalone Thoracoscopic Left Atrial Appendage Closure Versus Medical Therapy in Atrial Fibrillation
Key facts
- Where
- Lund, SwedenSee the site
Where in Sweden
- Skanes universitetssjukhusLund, SwedenNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Region Skane
- Trial code
- NCT07705282
- Record updated
- 15 July 2026
- Original description
Surgical left atrial appendage closure (LAAC) has been associated with reduced rates of stroke in patients with atrial fibrillation (AF) who have undergone cardiac surgery. In recent time, procedures with catheter-based devices for LAAC have failed to achieve results that would make them considered a safe alternative to oral anticoagulation. Several concerns regarding catheter-based devices have been raised due to their contact with circulating blood, device migration and periprocedural complications. LAAC using an externally placed clip via thoracoscopy would elude some of these concerns and may therefore be a feasible alternative to oral anticoagulation in patients with AF.Read full original descriptionShow less
Standalone Thoracoscopic Left Atrial Appendage Closure Versus Medical Therapy in Atrial Fibrillation
Surgical left atrial appendage closure (LAAC) has been associated with reduced rates of stroke in patients with atrial fibrillation (AF) who have undergone cardiac surgery. In recent time, procedures with catheter-based devices for LAAC have failed to achieve results that would make them considered a safe alternative to oral anticoagulation. Several concerns regarding catheter-based devices have been raised due to their contact with circulating blood, device migration and periprocedural complications. LAAC using an externally placed clip via thoracoscopy would elude some of these concerns and may therefore be a feasible alternative to oral anticoagulation in patients with AF.
This study aims to assess whether thoracoscopic left atrial appendage closure (TLAAC) is noninferior to medical treatment in patients with AF and an elevated bleeding risk using or being planned to initiate OAC and in those patients with clinical contraindications to oral anticoagulants.
Inclusion: Age ≥ 18 years and any of criteria 2-3; AF with a CHA2DS2-VA score ≥2 and a HAS-BLED score ≥3 or other clinically significant bleeding condition and ongoing OAC treatment; AF with a CHA2DS2-VA score ≥2 but deemed unfit for OAC by responsible physician due to clinical contraindications (e.g. amyloid angiopathy, previous intracranial haemorrhage or severe gastrointestinal bleeding).
Exclusion: Indication for dual antiplatelet therapy, if OAC is discontinued; Previous open-heart surgery; Previous radiation therapy of the chest, due to malignancy; Previous pericarditis or myocarditis; Previous surgery including access to the left pleural space; Ongoing treatment with corticosteroids or previous treatment for more than 3 consecutive months; Present indication for cardiac surgery; Documented FEV1<70% or other significant pulmonary disease (including but not restricted to fibrosis, pulmonary post-covid syndrome, cystic fibrosis); Allergy to contrast media; Clinical frailty score ≥5; Indication for OAC other than AF; Present indication for ablation for atrial fibrillation; Patient already included in another interventional clinical trial; Patient listed abroad, which would render them to be lost to follow-up after discharge; Patient does not understand study information given in the local language or, for other reasons, is deemed unfit to participate according to the investigators.